显微镜下手术治疗高血压基底节脑出血的疗效观察

目的 观察显微镜下手术治疗用于高血压基底节脑出血的临床疗效，为临床应用提供理论依据。 方法 选择2016年11月—2019年9月于滁州市第一人民医院行手术治疗的62例高血压基底节脑出血患者为研究对象，采用随机数字表法分为观察组和对照组，其中观察组32例，采用显微镜下手术治疗，对照组30例，采用传统开颅手术治疗。比较2组患者的一般临床资料、手术时间、术中出血量、术后住院期间常见并发症(再出血、肺部感染、脑梗塞、应激性溃疡和癫痫)的发生率和术后3个月的格拉斯哥预后分级(Glasgow outcome scale，GOS)情况。 结果 观察组手术时间为(171.18±38.65) min，少于对照组[(183.67±33.50) min]，差异无统计学意义(P=0.181)；观察组术中出血量为(164.06±36.71) mL，少于对照组[(178.67±38.48) mL]，差异无统计学意义(P=0.131)；观察组术后住院期间常见并发症的发生率为40.63%，明显低于对照组(70.00%)，差异具有统计学意义(P=0.020)；术后3个月观察组患者的GOS分级预后良好率为65.63%，明显高于对照组的40.00%，差异具有统计学意义(P=0.043)。 结论 相比于传统手术，显微镜下手术治疗高血压基底节脑出血，具有并发症发生率低且近期预后较好的优势，值得在临床进一步普及。 

Curative effect observation of microsurgery for hypertensive basal ganglia cerebral hemorrhage

Objective To investigate the clinical effect of microsurgery for hypertensive basal ganglia cerebral hemorrhage and provide theoretical basis for clinical application. Methods Total 62 patients with hypertensive basal ganglia cerebral hemorrhage who underwent surgery at the First People's Hospital of Chuzhou from November 2016 to September 2019 were selected as research subjects. They were simply and randomly divided into observation group and control group, and 32 cases in the observation group were treated with microscope, 30 patients in the control group were treated with traditional craniotomy. χ2 test and t test were used to compare the general clinical data of two groups, t test was used to compare the operation time and intraoperative blood loss of the two groups, and χ2 test was used to compare common complications (rebleeding, pulmonary infection, cerebral infarction, stress ulcers, and epilepsy) during postoperative hospitalization, and the Glasgow outcome scale (GOS) at 3 months after surgery in the two groups. Results The operation time in the observation group was (171.18±38.65) minutes, which was shorter than that in the control group[(183.67±33.50) minutes], the difference was not statistically significant (P=0.181). The intraoperative blood loss in the observation group was (164.06±36.71) mL, which was less than that in the control group[(178.67±38.48) mL], the difference was not statistically significant (P=0.131). The incidence of common complications during the postoperative hospital stay in the observation group was 40.63%, which was significantly less than 70.00% in the control group, the difference was statistically significant (P=0.020). The good prognosis of GOS classification in the observation group was 65.63% at 3 months after operation, which was significantly higher than that in the control group (40.00%), the difference was statistically significant (P=0.043). Conclusion Compared with traditional surgery, microsurgery for hypertensive basal ganglia cerebral hemorrhage has the characteristics of low complication rate and better recent prognosis, which is worthy of clinical application.